Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Empathy Sympathy

Empathy vs. Sympathy

Empathy, sympathy and compassion are often poorly understood, inadequately defined and easily confused.
Empathy and sympathy are emotions that serve two different but related functions. In the case of sympathy, you feel for the patient; you feel sorry for them but may not necessarily understand fully what they are experiencing. You may feel pity for the emotions they are confronting, but you do not share those feelings, merely regret that they must experience them.

Someone treating a patient in pain may be quite sympathetic. They know why and where the patient experiences the pain. They do not know how the pain feels to the patient, merely that they are certain the patient is quite uncomfortable and unhappy. However, patients have difficulty with this differentiation. They want those who treat them to be more empathetic, to share in the misery, to have experienced the discomfort, discouragement, helplessness and desperation.

A lack of empathy results in the distance patients feel from their doctors. They feel that the person treating them may have a modicum of sympathy/pity, but they also feel that the doctor is not “there for them” right beside them, dealing with the problem directly with them; empathy.

There is a related third term that friends, family and health care providers can express: compassion. Even if unable to directly experience the misery of the patient in pain, others can express how sorry they are that the patient suffers and how much they wish the patient to feel better and to be able to manage all that confronts him/her. Thus, whether an individual experiences sympathy or empathy, he/she can express compassion.

Now, here is the difficulty: Many patients do not feel that those who treat them are compassionate. They often see their providers as aloof or indifferent and failing to register the patient’s degree of discomfort.
When a patient is in a cancer or pain support group, they feel that other group members share (empathize not merely sympathize) with their plight.

They often obtain a similar response in a waiting room where other pain patients are present. The latter is not always a positive or therapeutic experience.

However, in the presence of a healthy, fully functioning health care provider, they often feel alone, not fully understood, and that their misery is being dismissed as familiar, predictable, uninteresting or even boring.
The ability to communicate to the patient that all aspects of his/her pain are well understood and that compassion is felt, often results in greater cooperation with treatment plans, and certainly fosters a better doctor-patient relationship.

However, too often the patients are correct: The communication from doctor to patient is “this is how I treat your pain. I know about the causes of pain. But how it impacts your particular life? That is not what I do.”